Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
Claims adjudication services cover a range of areas including medical, dental, vision, and prescription claims, as well as short and long-term disability cases. These services can be accessed either on-site with a license or through a hosted application model (ASP). Utilizing Microsoft technology, the system is powered by an SQLServer database paired with a Windows front end. Our customer service is highly regarded, staffed by healthcare claims professionals who boast a minimum of 12 years of industry experience. All support inquiries are recorded, and their statuses can be monitored online. The system features a plan copy and modification tool that facilitates rapid plan implementation. Auto-adjudication is achieved through benefit codes that are constructed using business rules derived from over 25 variables connected to both the claims and the claimants, which are then processed by the adjudication engine. Claims can be submitted in various formats, including scanned images, EDI, or paper submissions. The system is compliant with HIPAA EDI 5010 transaction sets, ensuring secure and efficient processing. Additionally, re-pricing fees and UCR schedules can be pre-loaded into the system prior to their effective dates, while the date-driven logic ensures that re-pricing occurs based on the service date, optimizing the claims processing workflow. The comprehensive nature of this system allows for a more streamlined and efficient claims management experience.
Description
MarvelX delivers AI-driven claims agents designed for the automation of claims processing. This innovative platform efficiently manages extensive claims workflows starting from the first notice of loss (FNOL) all the way through to policy validation, adjudication, and settlement, enabling insurers to reduce claims handling durations from several days to under an hour while increasing their capacity without the need for additional personnel. Specifically tailored for property and casualty (P&C), motor, travel, health, life, as well as embedded insurers, along with managing general agents (MGAs) and third-party administrators (TPAs), MarvelX systematically verifies policy information, ensures all submitted documents are complete, and directs any complex cases to human reviewers. Each decision made maintains a human oversight, resulting in outputs that are ready for audits. For teams requiring data without decision-making, MarvelX also provides AI-driven document data extraction for insurance, delivering structured fields from various claims documents, invoices, and policies, along with references to the original documents. Additionally, MarvelX seamlessly integrates with existing systems that claims teams already utilize, such as HubSpot and Dutch registries like KVK, RDW, and SchadeGarant, facilitating a smoother workflow. Overall, MarvelX represents a significant advancement in claims processing efficiency and accuracy.
API Access
Has API
API Access
Has API
Integrations
HubSpot CRM
Pricing Details
No price information available.
Free Trial
Free Version
Pricing Details
Price on request
Free Trial
Free Version
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Vendor Details
Company Name
Complete Health Systems
Website
completehealthsys.com/claims/
Vendor Details
Company Name
MarvelX.ai
Founded
2025
Country
Netherlands
Website
Marvelx.ai
Product Features
Claims Processing
Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration
Product Features
Claims Processing
Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration